Cognitive Exam

Assessing Sedation


Richmond Agitation-Sedation Scale

  • A scale used to assess level of sedation, mainly in ICU patients.
    • Interpretation

    • +4
      Combative: violent, immediate danger to staff
    • +3
      Very agitated: pulling or removing tubes; aggressive
    • +2
      Agitated: Frequent non-purposeful movements; fights ventilator
    • +1
      Restless: anxious without aggressive or vigorous movement
    • 0
      Alert and calm
    • -1
      Drowsy: Not alert, but sustained eye contact to voice (>10 seconds)
    • -2
      Light sedation: briefly awakens with eye contact to voice (<10 seconds)
    • -3
      Moderate sedation: movement or eye opening to voice with no eye contact
    • -4
      Deep sedation: no response to voice, movement or eye opening to physical stimulation
    • -5
      Unrousable: no response to voice or physical stimulation
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